Ab0988 Telomere Length Association With Clinical Characteristics and Cognition in Patients With Systemic Lupus Erythematosus: A Cross-Sectional Study

Background: Telomeres are protein complexes located at the top of each arm of chromosomes, essential for maintaining the stability of the genome. Telomere shortening is found in physiological aging and senescence-related to systemic lupus erythematosus (SLE). Objectives: To compare the relative telomere length (TL) in patients with SLE and controls and to correlate the TL with clinical characteristics, treatments, disease activity, and damage. Methods: A cross-sectional study comparing SLE patients and controls, from 18 to 60 years old, matched by sex and age. Clinical and demographic data from all participants were collected, and relative TL by qPCR. For cases, previous and current history, disease activity, damage, cognitive assessment, fatigue, presence of depression, anxiety, stress symptoms, and physical activity were analyzed. Results were obtained using frequencies and percentages for qualitative characteristics and measures of central tendency and standard deviation for quantitative ones. Comparisons of relative TL and other variables were performed using the t-Student test when assumptions of normality and homoscedasticity were satisfied and the Mann-Whitney test otherwise. A significance level of 5% was considered. Results: Sixty SLE patients and 55 controls were included. Among patients, 75% were diagnosed in adulthood; 86.7% were female (mean age 37 years); 15% had antiphospholipid syndrome (APS), 51.7% had a previous history of nephritis, and 23.3% had neuropsychiatric involvement. Among controls, 87.3% were female (mean age 38 years). There was no difference between groups regarding sex and age (p=0.924 and p=0.737, respectively). SLE patients had a median relative TL of 0.80 versus 1.07 in the control group (p=0.005). In the multiple regression model (R²=18.4%), patients with anxiety symptoms in a moderate grade had lower TL (p=0.015) when compared to patients without or with low-grade anxiety symptoms. In contrast, patients with APS had longer telomere when compared to patients without APS (p=0.007). There was no association with disease activity or damage. Conclusion: Brazilian SLE patients have shorter telomeres than controls. Telomere length in SLE patients was associated with anxiety symptoms. Longitudinal studies are essential to evaluate clinical implications related to TL. REFERENCES: [1] LEE, Y. H. et al. Association between shortened telomere length and systemic lupus erythematosus: a meta-analysis. Lupus, v. 26, n. 3, p. 282-288, Mar 2017. [2] BRIDGES, J. et al. Leukocyte Telomere Length and Childhood Onset of Systemic Lupus Erythematosus in the Black Women's Experiences Living with Lupus Study. ACR Open Rheumatol, v. 4, n. 5, p. 426-431, May 2022. [3] HAQUE, S. et al. Shortened telomere length in patients with systemic lupus erythematosus. Arthritis Rheum, v. 65, n. 5, p. 1319-23, May 2013. [4] UGARTE-GIL, M. F. et al. Circulating CD4+CD28null and extra-thymic CD4+CD8+ double positive T cells are independently associated with disease damage in systemic lupus erythematosus patients. Lupus, v. 25, n. 3, p. 233-40, Mar 2016. Acknowledgements: Brazilian Society of Rheumatology for funding this study. Disclosure of Interests: None declared.